Trauma Centers have historically functioned as critical medical resources and communication hubs for both natural and human-caused catastrophes of mass scale. They are organized so that injured patients are rapidly triaged, assessed, and treated as tested in the 1993 and 2001 World Trade Center terrorist attacks, the attack on the Oklahoma City Murrah Building, and natural disasters of all types nationwide. Our premise is that this capability and capacity will vary where trauma systems are not developed or fully implemented, or where trauma centers are economically or resource threatened . Despite their role in disaster/terror response, a 2004 NFTC survey of EMS/trauma systems identified only two (2) States (FL, NC) that had provided any direct fiscal support for trauma system preparedness for terror attacks, and those amounts allocated were meager. No national evaluation of the effect upon a trauma center from a terrorist blast attack has been conducted. Therefore, trauma centers lack practical examples to help them prepare for the resultant mass casualties and will benefit from the experiences of highly performing and best practice trauma centers identified in this study. The project deliverables will be written, audiovisual, and educational information that can be adapted to any trauma center's unique circumstances. The program addresses the "Healthy People 2010" focus area(s) of Injury and Violence Prevention and will occur in two (2) phases. Phase I: Develop and conduct a survey of all known verified, designated, or functional Level I and II trauma centers to identify the degree to which they meet key characteristics of a well prepared trauma center in the event of a Blast-type terror attack, including one with the potential for biological, chemical, nuclear agents and other hazards. Phase II: Selected trauma centers will undergo a site visit, provide appropriate documents, and participate in a summary review of their their preparation for a blast-type terror attack as defined in the grant. The public will benefit by trauma centers becoming better prepared for a Blast-type terror attack. Trauma centers need templates from highly performing trauma centers and best practices in areas of preparedness where few trauma centers report readiness in order to meet the needs of the injured public when and if this type of event occurs.